Problems with breastfeeding

There are some common problems that women have when breastfeeding. Find out about sore nipples, engorged breasts, blocked milk ducts and your milk supply, with tips to manage them.

Sore nipples

You may have sore nipples until your breasts become used to breastfeeding. Nipples are usually most sore in the first week after baby’s birth. They should feel better 7–10 days after baby’s birth.

During that first week the initial soreness should wear off 15–30 seconds after the baby has latched. If it doesn’t, ask your midwife for help. You may need help with positioning and latching your baby.

If nipple soreness continues into the second week, or gets worse rather than better, get help. If there is a problem with baby’s latch this can be corrected, or the soreness may be due to another issue.

Breasts feel sore and hard (engorgement)

Many women’s breasts start to feel full, sore and hard as their milk supply increases (the milk ‘comes in’). This feeling is most common 3–5 days after baby’s birth. If your breasts are really sore and hard, and feel too full, it helps to put something cool on them after a feed. This can reduce the hot, swelling feeling.

If your baby is finding it tricky to get a good latch, you can hand express a little milk first. This will soften the areola (the darker area around the nipple) so that it’s easier for baby to latch – and less painful for you.

Blocked milk ducts and mastitis

Talk to your midwife or doctor straight away if you feel unwell and part of your breast is red or feels sore, hot or lumpy. You may have a local inflammation caused by a blocked milk duct or a more general breast infection (mastitis). It is better for you and baby if you continue breastfeeding.

It is important to empty the sore breast; if this is too hard to begin with, feed from the other side until the sore side ‘lets down’. Be sure to empty the sore side by feeding or pumping. Massaging the sore area gently at the same time can help, as does warming the breast before feeding. Emptying the breast will help to reduce the blockage and keep your milk flowing. It is important that you have bed rest for at least 24 hours and that you drink plenty of fluid.

Keep the sore area warm with a wheat pack or wrapped hot water bottle, or cold pack if preferred – whatever will help you to feel more comfortable. Your midwife or doctor may if necessary prescribe an antibiotic to reduce the inflammation, but if caught early this is not usually necessary. Wear a supportive bra that does not cause painful pressure.

Some babies will be able to empty both breasts every time they feed. Others will be full after one. Although babies often prefer one breast, make sure that baby feeds from both breasts throughout the day to avoid blocked milk ducts.

If you’re worried baby isn’t getting enough milk

Sometimes you may feel as if you don’t have enough milk. This is hardly ever the case. Babies normally have some breastfeeds close together (this is called cluster feeding). They also breastfeed more often when they’re going through a growth spurt. Sometimes they are fussy and unsettled, but that’s just because they are new babies and going through normal newborn unsettled periods.

Remember that the more often that breast milk is removed from the breast by a baby, the more milk will be produced.

Look after yourself

You need to look after yourself while breastfeeding, which might mean asking others to help you too. Make sure that you eat a well balanced diet and drink lots of water. Avoid alcohol, caffeine and smoking, as these can affect your milk supply and your baby’s health.

Related websites

Breastfeeding NZ – YouTube channel and Facebook page
Breastfeeding information and videos. The YouTube channel contains the Breastfeeding. Naturally. video (as 7 separate chapters); these are also available with captions and in New Zealand Sign Language. The Facebook page is for anyone and everyone who is breastfeeding or interested in breastfeeding. Find out more, share your stories and get support from other members.